U.S. patent application number 11/449669 was filed with the patent office on 2007-12-13 for method and system of adjusting medical cost through auction.
Invention is credited to Kenji Sakaue, Reiko Sakaue.
Application Number | 20070288262 11/449669 |
Document ID | / |
Family ID | 38822991 |
Filed Date | 2007-12-13 |
United States Patent
Application |
20070288262 |
Kind Code |
A1 |
Sakaue; Kenji ; et
al. |
December 13, 2007 |
Method and system of adjusting medical cost through auction
Abstract
To provide a medical cost adjusting method for suppressing a
medical cost to a reasonable price so that a person who suffers
from a disease can receive an appropriate medical service even if
the person is not insured. A medical institution presents a
predicted medical cost to be demanded therefrom for a medical
service given to a patient as a desired demanding amount and, on
the other hand, the patient, who desires to receive the medical
service, presents a payable medical cost as a desired medical
treatment amount, thus, matching of the desired demanding amount to
the desired medical treatment amount is carried out. Accordingly,
it is possible of integrating a reverse auction and a regular
auction making it possible of efficiently collect members concerned
in the auction trade. In the reverse auction, a medical cost is
used as an article of trade between a medical institution and a
patient. That is, the integrated auction according to the present
invention is an auction structure between members wherein a demand
for an article of trade is attempted to meet a supply of the same,
and this brings about a condition where there is a high possibility
of making a successful bid and an effect of markedly reducing a
medical cost as compared to a conventional medical cost.
Inventors: |
Sakaue; Kenji;
(Yokohama-shi, JP) ; Sakaue; Reiko; (Yokohama-shi,
JP) |
Correspondence
Address: |
JACOBSON HOLMAN PLLC
400 SEVENTH STREET N.W., SUITE 600
WASHINGTON
DC
20004
US
|
Family ID: |
38822991 |
Appl. No.: |
11/449669 |
Filed: |
June 9, 2006 |
Current U.S.
Class: |
705/2 ; 705/37;
705/4 |
Current CPC
Class: |
G06Q 10/10 20130101;
G06Q 40/08 20130101; G06Q 40/04 20130101; G06Q 30/08 20130101 |
Class at
Publication: |
705/2 ; 705/37;
705/4 |
International
Class: |
G06Q 10/00 20060101
G06Q010/00; G06Q 40/00 20060101 G06Q040/00 |
Claims
1. A medical cost adjusting method for determining a medical cost
for a medical service provided by a medical institution to a
patient, said method comprising, regarding each medical service: a
step of presenting a predicted medical cost as a desired providing
amount to be charged on a patient by said medical institution for a
medical treatment or aid, if given; a step of presenting an amount
payable for said medical service as a desired obtaining amount by
said patient; a step of determining session members as parties
concerned in an auction trade by integrating a reverse auction
trade wherein matching of pieces of information including at least
said desired obtaining amount and said desired providing amount for
a medical institution is carried out to make a bid for said desired
obtaining amount presented by said patient, and a regular auction
trade wherein a patient makes a bid for said desired providing
amount presented by said medical institution; a step of executing
an auction trade by said session members; and a step of ending an
auction trade when either of said medical institutions makes a bid
for said desired providing amount, which is lower than said desired
obtaining amount presented by said patient, or when a predetermined
auction ending time is passed.
2. A method according to claim 1, wherein pieces of information
presented by said patient and said medical institution are entered
to a database as user objects, attributes of said user objects
being defined as follows: a) when said patient and said medical
institution participate in a reverse auction trade, an attribute of
a user object created from information presented by said patient is
an active/obtaining type, and an attribute of information presented
by said medical institution is a passive/provision type, and b)
when said patient and said medical institution participate in a
regular auction trade, an attribute of a user object created from
information presented by said patient is a passive/obtaining type,
and an attribute of information presented by said medical
institution is an active/provision type.
3. A method according to claim 2, wherein when said matching is
carried out to determine session members as parties concerned in an
auction trade, any one of types of active/obtaining,
passive/provision, passive/obtaining and active/provision, which
are respective attributes of said user objects, is distinguished to
generate a regular auction group or a reverse auction group.
4. A method according to claim 1, wherein when said matching is
carried out to determine session members as parties concerned in an
auction trade, information including at least a contracted
insurance information is included in said information subjected to
said matching as well as amounts of medical costs presented by said
patient and said medical institution, respectively.
5. A method according to claim 1, further comprising: a step of
accepting a donation from a third party other than said session
members as parties concerned in an auction trade; and a step of
adjusting an amount on the basis of a desired obtaining amount
whereto said accepted donation amount is added and a desired
providing amount wherefrom said accepted donation amount is
subtracted so that an auction trade can be carried out.
6. A method according to claim 5, wherein said donation is applied
with a part of earnings obtained from a specific action by a
non-personal party including a third party or a corporation having
no intention to directly make a donation for a medical cost.
7. A method according to claim 6, wherein said earnings obtained by
a specific action by a third party includes a lottery held by
investments made by unspecified many parties and a winning number
thereof is determined on the basis of a plurality of pieces of
winning information including at least one piece of coded winning
factor information.
8. A method according to claim 7, wherein said winning factor
information includes an exchange rate and an average stock price in
one stock market or a plurality of stock markets and said winning
number is determined on the basis of a value obtained by converting
said average stock price into an exchange rate at a predetermined
time.
9. A method according to claim 5, wherein in said step of executing
an auction trade, when an upper limit of an obtaining amount
indicating that an amount exceeding the upper limit is unpayable is
presented by said patient, said desired obtaining amount is
adjusted or a bid is made for the same within the range of not more
than said upper limit of an amount.
10. A method according to claim 1 , wherein in said step of
executing an auction trade, appropriateness of price adjustment of
said desired providing amount or said desired obtaining amount is
evaluated on the basis of statistical analysis of results of
ballots or questionnaires collected from parties other than said
session members as parties concerned in an auction trade to adjust
said desired providing amount or said desired obtaining amount.
11. A medical cost adjusting method for determining a medical cost
for a medical service provided by a medical institution to a
patient, wherein, when a life insurance policy trading session such
as a viatical and life settlement trading is opened as a condition
to open an auction for said medical service, said medical cost
adjusting method comprising: (a) in said life insurance policy
trading session such as a viatical and life settlement trading, (i)
a step of putting up an insurance policy as an insurance commodity
at an auction by said patient; (ii) a step of making a bid for said
insurance policy as an insurance commodity by one or a plurality of
insurance companies; and (iii) a step of making a successful bid
for said one insurance company or one of said plurality of
insurance companies which has made a bid at a highest price of not
less than a specific price; or (b) in a session for said medical
service: (i) a step of presenting by said patient an insurance
money presented by said insurance company, which has made a
successful bid, as a payable desired obtaining amount for said
medical service; (ii) a step of presenting a predicted medical cost
as a desired providing amount charged on a patient by said medical
institution for a medical treatment or aid, if given; and (iii) a
step of ending an auction trade of said medical service when either
of said medical institutions makes a bid for said desired providing
amount, which is less than or equal to said desired obtaining
amount presented by said insurance company, or when a predetermined
auction ending time is passed.
12. A method according to claim 11, wherein when said patient
participates in said life insurance policy trading session such as
a viatical and life settlement trading, said patient is requested
for disclosure of a result of a medical examination of said patient
himself/herself so that said insurance company can use said medical
examination result to judge appropriateness of selling an insurance
policy as an insurance commodity or to adjust an insurance due.
13. A method according to claim 11, wherein an insurance due of an
insurance policy as an insurance commodity traded in said life
insurance policy trading session such as a viatical and life
settlement trading may be adjusted on the basis of probability data
derived from a death rate of each person in each age or by
referring to personal living information of said patient.
14. A method according to any one of claims 11, further comprising:
a step of accepting a donation for a patient or an insurance
company in said life insurance policy trading session such as a
viatical and life settlement trading, wherein said insurance
company which has accepted said donation gives a preferential
treatment regarding an insurance due of an insurance policy as an
insurance commodity to a party which has made a donation.
15. A method according to claim 14, wherein result information of
said donation is recorded and displayed in a comparable manner with
other donators.
16. A method according to claim 1, wherein biographical information
of said patient is detected during an auction and compared with
master data of said patient registered in advance for personal
authentication, lie detection, emotion recognition or health
checking of said patient.
17. A method according to claim 11, wherein biographical
information of said patient is detected during an auction and
compared with master data of said patient registered in advance for
personal authentication, lie detection, emotion recognition or
health checking of said patient.
18. A method according to claim 16, wherein said biographical
information of said patient includes at least one of a voice, an
expression on a face, an iris, a retina, a voice printing, a body
temperature, a pulse, a brain wave, a blood pressure and a
cutaneous electrical resistance.
19. A method according to claim 17, wherein said biographical
information of said patient includes at least one of a voice, an
expression on a face, an iris, a retina, a voice printing, a
fingerprint, a biomembrane, a blood vessel and a capillary of human
hands and other parts of human living body, a body temperature, a
pulse, a brain wave, a blood pressure and a cutaneous electrical
resistance.
20. A medical cost adjusting system for determining a medical cost
for a medical service provided by a medical institution to a
patient through an auction trade, said medical cost adjusting
system comprising: a system server connected via a network; a
patient terminal; and a medical institution terminal, (a) said
patient terminal transmitting a payable amount for said medical
service as a desired obtaining amount to said system server via
said network, (b) said medical institution terminal transmitting a
predicted medical cost as a desired amount to be charged on a
patient for a medical treatment or aid, if given, (c) said system
server (i) determining session members as parties concerned in an
auction trade by matching pieces of information including at least
said desired obtaining amount and said desired providing amount to
integrate a reverse auction trade, wherein a medical institution
makes a bid for a desired obtaining amount presented by said
patient, and a regular auction trade, wherein a patient makes a bid
for a desired providing amount presented by said medical
institution; (ii) carrying out an auction trade by said session
members; and (iii) ending an auction trade when either of said
medical institutions makes a bid for said desired providing amount,
which is less than or equal to said desired obtaining amount
presented by said patient, or a predetermined auction ending time
is passed.
21. A medical cost adjusting system for determining a medical cost
for a medical service provided by a medical institution to a
patient through an auction trade including a subsystem wherein a
life insurance policy trading session such as a viatical and life
settlement trading is opened as a condition to open an auction for
said medical service and, (a) in said subsystem for said life
insurance policy trading session such as a viatical and life
settlement trading: (i) said patient transmits information about an
insurance policy as an insurance commodity to a subsystem server
via a network; (ii) one insurance company or a plurality of
insurance companies transmits (transmit) a bid for said information
about an insurance policy as an insurance commodity to said
subsystem server via said network; (iii) said subsystem server
determines to make a bid for said one insurance company or one of
said plurality of insurance companies which has made a bid at a
highest price of not less then a specific price; (b) in a system
where said medical service auction is opened: (i) said patient
transmits an insurance money presented by said insurance company
for which a bid was made in said subsystem as a payable desired
obtaining amount for said medical service to said system server via
said network; (ii) said medical institution transmits a predicted
medical cost as a desired providing amount to be charged on a
patient for a medical treatment or aid, if given; and (iii) said
system server ends an auction trade for said medical service when
either of said medical institutions makes a bid for said desired
providing amount, which is less than or equal to said desired
obtaining amount presented by said insurance company, or a
predetermined auction ending time is passed.
22. A system according to claim 20, wherein an auction trade for
said medical service is carried out upon adjustment of said desired
obtaining amount or said desired providing amount by using a
donation made by a person or an organization unrelated to a trade
of said medical service or earnings obtained by a specific action
of said person or said organization.
23. A system according to claim 21, wherein an auction trade for
said medical service is carried out upon adjustment of said desired
obtaining amount or said desired providing amount by using a
donation made by a person or an organization unrelated to a trade
of said medical service or earnings obtained by a specific action
of said person or said organization.
Description
FIELD OF THE INVENTION
[0001] The present invention relates to an auction method for
adjusting a reasonable price for a medical service and, more
particularly, to a technique for integrating a regular auction and
a reverse auction to incorporate supports of many and unspecified
third parties into a means to reduce a medical cost.
CROSS REFERENCE OF RELATED APPLICATION
[0002] The following U.S. patent application is hereby incorporated
by reference in its entity as though fully and completely set forth
herein: U.S. application Ser. No. 11/077,038.
BACKGROUND ART
[0003] Usually, when a person suffers from a disease and receives a
medical service at a medical institution, the person needs to pay a
medical cost as a counter value for the service. In some countries
in the world, an individually paid medical cost is relatively a
small amount by virtue of a social insurance system, whereas, in
other countries, each patient must pay almost entire medical cost
charged on the patent by a medical institution. When a medical
service is given by a medical treatment stuff in a medical
institution having high specialties and techniques, a medical cost
charged on each patient tends to be very high, however, the patient
is usually not sufficiently given an opportunity to raise an object
to the appropriateness of the charged cost.
[0004] Accordingly, the patient having no scope of a negotiation on
a medical cost is in a disadvantageous position in that, even the
patient hopes to receive a desired medical service, he or she has
no choice but to give up receiving the service for an economic
reason. Particularly in countries such as the USA, high burdens of
medical costs are social problems for the people except for some
people with large incomes and wealth, and a remarkable social
phenomenon is that even a person in a serious condition cannot
undergo a medical treatment just because he or she is unable to pay
the medical cost.
[0005] The problem of an increasing medical cost is not the problem
for only patients. In many cases, people personally contract
medical insurance as a preparation for the payment of high medical
costs, however, an insurance company faces a trouble in that the
payment of high medical costs with insurance money presses the
management thereof, however, raising insurance dues to be collected
from insured persons results in reduction of the number of insured
persons. Accordingly, the reduction of the increasing medical cost
is a fundamental and urgent subject.
[0006] On the other hand, taking into consideration of incentives
of the beneficiary liability and the market principle under the
capitalism, such behaviors as demanding a high charge from a
patient as a counter value for a medical service of a high
technical level or providing a medical doctor having such a
high-level medical technique and therefore taking a large amount of
fee should not be the targets of one-sided criticism. The matter of
concern is that medical costs tend to be extremely increased
resulting in that, even people suffering from a slight disease
cannot receive medical services whereas only limited number of
wealthy people can. Further, the basis of the high medical cost is
not purely derived from the above market principle, but a cost for
an expected medical lawsuit and the like is included in the medical
cost. Accordingly, the serious problems is that the social
environment, wherein some people cannot receive appropriate medical
treatments due to the income gap, has actually been formed.
[0007] Accordingly, the present invention has been made to solve
the above problems and an object thereof is to provide a medical
cost adjusting method for suppressing a medical cost to a
reasonable price so that even people with small incomes can receive
appropriate medical services when they suffer from diseases even if
they are insured or not insured, and the adjustment of the
reasonable price causes no disadvantage for medical institutions
and insurance companies as well as patients.
SUMMARY OF THE INVENTION
[0008] The medical cost adjusting method according to the present
invention is a method for determining a medical cost for a medical
service provided by a medical institution to a patient through an
auction trade, wherein, regarding each medical service, the medical
institution presents a predicted medical cost as a desired
providing amount to be charged on a patient for a medical treatment
or aid, if given; the patient presents a payable amount for the
medical service as a desired obtaining amount; session members are
determined as parties concerned in an auction trade by integrating
a reverse auction trade, wherein matching of pieces of information
including at least the desired obtaining amount and the desired
providing amount is carried out for a medical institution to make a
bid for the desired obtaining amount presented by the patient, and
a regular auction trade, wherein a patient makes a bid for the
desired providing amount presented by the medical institution; an
auction trade is carried out by the session members; and an auction
trade is ended when either of the medical institutions makes a bid
for the desired providing amount, which is less than or equal to
the desired obtaining amount presented by the patient, or when a
predetermined auction ending time is passed.
[0009] Further, the medical cost adjusting method according to the
present invention is a method for determining a medical cost for a
medical service provided by a medical institution to a patient
through an auction trade, wherein a life insurance policy trading
is opened as a condition to open an auction for the medical
service, the medical cost adjusting method comprising, (a) in the
life insurance policy trading: (i) a step of putting up an
insurance policy as an insurance commodity at an auction by the
patient; (i) one insurance company or a plurality of insurance
companies makes (make) a bid for the insurance policy as an
insurance commodity; (iii) a step of making a successful bid for
the one insurance company or one of the plurality of insurance
companies which has made a bid at a highest price of not less than
a specific price; or (b) in a session for said medical service: (i)
a step of presenting by the patient an insurance money presented by
the insurance company, which has made a successful bid, as a
payable desired obtaining amount for the medical service; (ii) a
step of presenting a predicted medical cost as a desired providing
amount charged on a patient by the medical institution for a
medical treatment or aid, if given; and (iii) a step of ending an
auction trade of the medical service when either of the above
medical institutions makes a bid for the desired providing amount,
which is less than or equal to the desired obtaining amount
presented by the insurance company, or when a predetermined auction
ending time is passed.
[0010] The medical cost adjusting system according to the present
invention is a system for determining a medical cost for a medical
service provided by a medical institution to a patient through an
auction trade, the medical cost adjusting system comprising a
system server connected via a network, a patient terminal and a
medical institution terminal, (a) the patient terminal transmitting
a payable amount for the medical service as a desired obtaining
amount to the system server via the network; (b) the medical
institution terminal transmitting a predicted medical cost to be
charged on a patient for a medical treatment or aid, if given, to
the system server via the network; (c) the system server (i)
determining session members as parties concerned in an auction
trade by matching pieces of information including at least the
desired obtaining amount and the desired providing amount to
integrate a reverse auction trade, wherein a medical institution
makes a bid for a desired obtaining amount presented by the
patient, and a regular auction trade, wherein a patient makes a bid
for a desired providing amount presented by the medical
institution; (ii) carrying out an auction trade by the session
members; and (iii) ending an auction trade when either of the above
medical institutions makes a bid for the desired providing amount,
which is less than or equal to the desired obtaining amount
presented by the patient, or a predetermined auction ending time is
passed.
[0011] The medical cost adjusting system according to the present
invention is a system for determining a medical cost for a medical
service provided by a medical institution to a patient through an
auction trade, the medical cost adjusting system including a
subsystem wherein a life insurance policy trading is opened as a
condition to open an auction for the medical service and, (a) in
the subsystem of the life insurance policy trading: (i) the patient
transmits the life insurance policy information to a subsystem
server via a network; (ii) one insurance company or a plurality of
insurance companies transmits (transmit) a bid for the life
insurance policy to the subsystem server via the network; (iii) the
subsystem server determines to make a successful bid for the one
insurance company or one of the plurality of insurance companies
which has made a bid at a highest price of more than a specific
price; or (b) in the system wherein the medical service auction is
opened: (i) the patient transmits an insurance amount presented by
the insurance company which has made a bid in the subsystem as a
payable desired obtaining amount for the medical service to the
system server via the network; (ii) the medical institution
transmits a predicted medical cost as a desired providing amount to
be charged on a patient for a medical treatment or aid, if given,
to the system server via the network; and (iii) the system server
ends the trade of the medical service when either of the above
medical institutions makes a bid for the desired providing amount,
which is less than or equal to the desired obtaining amount
presented by the insurance company, or when a predetermined auction
ending time is passed.
[0012] According to the method of adjusting a medical cost through
an auction according to the present invention, a predicted medical
cost to be charged by a medical institution after providing a
medical service to a patient is presented as a desired amount of a
charge and, on the other hand, the patient who desires to accept
the medical service presents a payable medical cost as a desired
medical charge, thus matching of the desired amount of charge to
the desired medical charge is carried out. Accordingly, a reverse
auction and a regular auction carried out using a medical cost as
an article of trade between the medical institution and the patient
can be integrated making it possible of efficiently collect members
concerned in the auction trade. That is, the integrated auction
according to the present invention is an auction structure between
members wherein a demand for an article of trade is attempted to
meet a supply of the same, and this brings about a condition where
there is a high possibility of making a successful bit and an
effect of markedly reducing a medical cost as compared to a
conventional medical cost.
[0013] Further, the present invention is constructed to accept
donations so that many and unspecified third parties other than
medical institutions and patients can participate in an auction
trade and therefore, a part or all of medical costs are supported
by the donations to give relief to patients conventionally having
difficulties in receiving medical services due to high medical
costs. Furthermore, this system of the integrated auction and the
participation of the third parties in the auction results in the
improvement in the business management of a medical institution and
the reduction of an amount paid by an insurance company as well as
the reduction of an amount paid by a patient resulting in the
realization of mutual relief aid in the entire society.
BRIEF DESCRIPTION OF THE DRAWINGS
[0014] In the Drawings:
[0015] FIG. 1: A basic block diagram of a medical cost adjusting
system of one embodiment according to the present invention.
[0016] FIG. 2: A view showing an example of an input screen for
information presented from a patient and a medical institution.
[0017] FIG. 3(a): A view showing an example of a data item included
in a user object.
[0018] FIG. 3(b): A view showing an example of a data item included
in a user object.
[0019] FIG. 4: A flowchart showing an algorithm for automatically
determining a medical cost at a reverse session auction as a main
form.
[0020] FIG. 5: A basic block diagram of a medical cost adjusting
system of one embodiment according to the present invention.
[0021] FIG. 6: A flowchart showing an algorithm for automatically
determining a medical cost at a regular session auction as a main
form.
[0022] FIG. 7: A schematic diagram showing a flow of a
donation.
[0023] FIG. 8: A view showing an auction in a form of integrating a
session trade of a medical service and a life insurance policy
trading session.
DESCRIPTION OF THE PREFERRED EMBODIMENT
[0024] The medical cost adjusting method includes a medical
treatment bill which hospitals charges to patients based on
hospitals and doctors to attend a medical treatment and a medical
service to patients and their needs. The system for realizing the
medical cost adjusting method according to the present invention
(hereinafter referred to as "the medical cost adjusting system") is
used to trade a medical cost, that is, a counter value for a
medical treatment, in the same manner as trading a substantial
commodity between a medical institution and a patient as a supplier
and a demander, respectively, through a communication line such as
a network (hereinafter referred to as "the network"). The medical
cost adjusting system is one type of a conventional auction system
in the sense of commercial trading of a network type, and has the
following features.
(1) Feature 1 (Integrated Session):
[0025] In a commodity trade by a conventional auction system, in
addition to a usual commodity trade on a network wherein a seller
presents a selling price for a commodity to be put up at an auction
(hereinafter referred to as "the commodity trade-type regular
session or the regular session"), there is a commodity trade
wherein a buyer presents a purchase price (hereinafter referred to
as "the commodity trade-type reverse session or the reverse
session"). These sessions are each carried out in an independent
form. Therefore, the sessions processed in the system are not
directly linked with each other and items put up at the both
sessions are not automatically announced to participants. In other
words, since the highest bid prices of commodities do not affect
each other, when the highest bit prices are attempted to be
determined in summarized trades in the regular session and the
reverse session, the intervention of a human operation is
inevitable. Consequently, the network auction cannot flexibly and
quickly meet with needs of a seller and a purchaser.
[0026] On the contrary, the basis of the medical cost adjusting
system of the present embodiment is an auction wherein a price for
a medical treatment is adjusted in a system wherein the commodity
trade-type regular session and the commodity trade-type reverse
session are integrated. The auction of the regular session is a
system of making a bid by a medical institution as a seller and a
patient as a buyer. A specific example is that, respective patients
make bids at 25,000 dollars and 30,000 dollars for a medical
service announced as "a gastric cancer will be operated at the
least price of 20,000 dollars" and a patient who proposes a highest
bid makes a successful bid for the service. On the contrary, in the
auction of the reverse session, the patient as a buyer presents a
desired medical cost, then medical institutions as sellers make
bids for acceptable medical costs for the operation and the patient
makes a successful bid for a medical institution which has made a
bid for the lowest medical cost for the operation. For example,
when the patient proposes "will any hospital accept a request for
an operation for a gastric cancer at the price of not more than
30,000 dollars?" then respective medical institutions make bids for
the proposal at 28,000 dollars and 25,000 dollars, the medical
institution which has presented a low price of 25,000 dollars makes
a successful bid.
[0027] According to the present invention, when the regular session
auction is carried out, matching search of a patient and a medical
institution is carried out by using a medical cost for the contents
of a medical service (for example, an upper limit of a payable
medical cost presented by a patient) as a keyword and, as a result,
a patient who desires to play a part in the reverse session auction
and to receive a medical service is treated as a participant of the
auction. Then, when the reverse session auction is performed,
matching search is carried out in the same manner using, for
example, a medical cost (for example, a lower limit of a price for
providing a medical service presented by a medical institution) as
a keyword, thereby treating a medical institution which desires to
play a part in the regular session auction as a participant of the
auction. The present invention is characterized in that the gap
between different sessions is thus eliminated to integrate the
regular session and the reverse session, and to realize an auction
as an integrated auction. In particular, in determination of a
medical cost traded mainly at the reverse session auction, a
patient presents an upper limit of a payable medical cost and a
medical institution having presented a lower limit of a medical
cost makes a bid, and therefore, a plurality of medical
institutions compete with each other at an auction for the lower
limit of a medical cost so that an effect of reducing a medical
cost can be expected.
(2) Feature 2 (Donation Accepting Mechanism):
[0028] A party concerned in a commodity trade by the conventional
auction system is a party directly concerned in sale and purchase
of a commodity to be traded except for a deputy of the party
concerned, and a case where a person who is not concerned in the
commodity trade at all plays a part in the conventional auction
system is not assumed.
[0029] On the contrary, the medical cost adjusting system of the
present embodiment has a mechanism to allow many and unspecified
third parties other than medical institutions and patients to
participate in a medical cost trade. Specifically, the third
parties are concerned in the auction system by making donations for
a medical cost to be paid by the patient. Even if an amount of a
donation from one person is small, a total amount of donations from
hundreds of thousands to millions of people is very large. A third
party being a member, who makes a donation of even a small amount
through the medical cost adjusting system, actively makes a
donation since it is possible that the third party is helped by
other members when suffering from a disease. Also, these donations
are advantageous for a patient in that the donations equally reduce
medical costs presented by a plurality of medical institutions as
well as greatly reducing self expenses of insurance companies.
Furthermore, the donations also contribute for medical institutions
to stabilize the business management thereof by obtaining patients
wherefrom medical costs can surely be collected.
[0030] Preferred embodiments of the present invention will be
described in detail hereunder with reference to the accompanying
drawings.
[0031] FIG. 1 is a basic block diagram of a medical cost adjusting
system 100. In the medical cost adjusting system 100, a medical
institution and a patient as a supplier and a demander,
respectively, trade a medical cost, that is, a counter value for a
medical treatment therebetween in the same manner as trading a
substantial commodity through a network 4. As shown in FIG. 1, each
patient uses one of patient terminals 1(1), . . . , 1(n)
(hereinafter represented by "the patient terminal 1(x)") connected
to the network 4 as an input means to enter desired "contents of a
medical service (for example, an operation for a gastric cancer)",
"a rate of a self expense (for example, 20%)" in a medical cost
charged by a medical institution, "an upper limit of a payable
amount (for example, 20,000 dollars)" of a medical cost estimated
on the basis of an insurance money received from an insurance
company" and the like. On the other hand, the medical institution
uses one of medical institution terminals 2(1), . . . , 2(n)
(hereinafter represented by "the medical institution terminal
2(x)") connected to the network 4 as an input means to enter "a
lower limit of a medical cost (for example, 28,000 dollars)" as a
counter value for a medical service desired to be received by the
patient which is estimated from past similar medical costs.
[0032] In addition, the above-described information to be entered
by the patient and the medical institution to the medical cost
adjusting system 100 are only a part of the information for making
it easy to understand the present invention, however, the
information to be entered is not limited to the above information.
In order to determine a medical cost agreeable between both the
patient and the medical institute by using the medical cost
adjusting system 100, pieces of detailed information about many
other patients and medical institutions are needed. The specific
information is described in an example of an information input
screen shown in FIG. 2.
[0033] A session server 3 stores the information entered from the
patient terminal 1(x) and the medical institution terminal 2(x) as
user objects. FIG. 3 shows an example of data items included in the
user objects. In particular, there is provided "(f4) object
function" as one function information item, and this information is
used to distinguish whether each user object is a passive object or
an active object from the functional characteristics of the each
user object. Furthermore, information about a purpose of using the
object such as provision or obtaining is added to determine a type
whereto the user object belongs from the following four types: (i)
active/provision, (ii) active/obtaining, (iii) passive/provision
and (iv) passive/obtaining.
[0034] In the case of the regular session auction, since the
medical institution (a seller side) as a promoter to start the
session (the medical institution is therefore active) presents the
provision of a service to the patient (a buyer side), a user object
created from information entered by the medical institution is an
"active/provision" type. Accordingly, since some patient can make a
successful bid for the medical service, a user object created from
information entered by the patient is a "passive/provision" type
object. Further, since the patient presents a desired medical cost
at the reverse session auction as a promoter to start the session,
a user object created from information entered by the patient is an
"active/obtaining" type and a user object created from information
entered by the medical institution is a "passive/provision"
type.
[0035] As described above, in order to effectively reduce a medical
cost by the present invention, it is appropriate to perform an
auction on the basis of the reverse session auction wherein a
patient can take initiative more easily than in the regular
session. Accordingly, the opening of the reverse session will be
described as an example, however, note that the significance of the
present invention is not lost even when the regular session auction
is opened. When information required of the patient to create an
active/obtaining type object including "contents of a medical
service", "a self expense rate", "an upper limit of a payable
amount (for example, 20,000 dollars") and other information shown
in FIG. 2 are entered via the patient terminal 1(x), these pieces
of information are set in data items of user objects shown in FIG.
3. In addition, it is desirable that entry by each patient can be
simplified by distinguishing the entry by the patient made at the
reverse session auction and automatically specifying the adjustment
of "(f4) object function" to an item to the "active/obtaining"
type. However, the patient may specify the item by himself or
herself.
[0036] The basic procedures of the reverse session auction will be
described hereunder. [0037] Procedure 1: The session server 3
issues a session start notification message to a medical
institution making a bid at the reverse session auction to notify
the start of a reverse session. The medical institution having
received this notification can grasp the contents of the session
through the screen of the medical institution terminal 2(x). The
contents of the session include, for example, a profile of a
patient, contents of a medical service, a desired medical cost and
a session start date. These contents are also outputted onto a
screen of an optional terminal connected to a session server via
the network 4 so that third parties other than bidders can also
refer to the contents. [0038] Procedure 2: The session server 3
further detects a medical institution which has opened a reverse
session auction by matching search and issues a session start
notification message. Then, the session server 3 starts a reverse
session auction when a session start date has come. The medical
institution having received the start notification is allowed to
participate in the auction without making a final bid and is free
to retreat from the auction. [0039] Procedure 3: The patient as a
promoter or the medical institution as a bidder can chose an
automatic or a manual (a human operation of) auction carried out
under the management of the session server 3 until a successful bid
is made. In the case where a successful bid is made automatically,
a medical cost is determined using predetermined parameters ("(f6)
parameters in automatic successful bid" shown in FIG. 3) in
accordance with an algorithm which will be described later.
<Automatic Determination Algorithm for Medical Cost>
[0040] FIG. 4 shows an example of a detailed algorithm for
automatic determination of a medical cost at the reverse session
auction as a main form. First, the session server 3 determines
session members before the start of the reverse session in steps
S41 to 44.
[0041] The session server 3 searches a medical institution which
desires to participate in the reverse session auction (step S41).
For this purpose, a passive/provision type object can be searched
in the registered user objects. The reason is that, the information
entered by the medical institution via the medical institution
terminal 2(x) is set as a user object of a passive/provision type
in the reverse session auction as described above. The session
server 3 further introduces the medical institution, which desires
to participate in the regular session auction (i.e., the
active/provision type user object), into the reverse session as a
member thereof. At this time, the number of search targets is
narrowed to a specific number (step S42). For example, when the
patient presents 30,000 dollars as an upper limit of a payable
amount for an operation for a gastric cancer, it is scarcely
possible that the medical institution which presents a lower limit
of a medical cost of 40,000 dollars makes a successful bid, and it
is therefore almost meaningless to allow this medical institute to
participate in the session as a member. Accordingly, the session
server 3 picks up only medical institutions which possibly accept
the demand of the patient by the matching search using AND
conditions including "an operation for gastric cancer" and "a lower
limit of a medical cost of not more than 30,000 dollars" as
matching keywords (step S43). The user objects of the reverse
session and the regular session thus selected are set as session
members in the present invention.
[0042] Next, donation acceptance processing required in processing
in steps S45 and subsequent steps will be described.
[0043] The information entered by the patient via the patient
terminal 1(x) includes an upper limit of a payable amount taking
into consideration of a self expense rate to a medical cost and an
insurance money received from an insurance company. On the other
hand, the information entered by the medical institution via the
medical institution terminal 2(x) includes a lower limit of a
medical cost estimated from past results of medical treatments.
When there is a great difference between these amounts, there is a
little chance of finally concluding a trade so that a deal is done
(making a successful bid) at the reverse session auction according
to the present invention. Accordingly, the donation acceptance
processing functions to conclude the trade so that the deal is done
at the reverse session auction by accepting donations from many and
unspecified third parties, which are not parties directly concerned
in the trade in the medical cost adjusting system 100 (session
members) but observing the session through the network 4, and to
reflect the donations to the essential reduction of the amount
presented by the medical institution.
[0044] As described above, the information related to the trade in
the session is disclosed on optional terminals 6(x) (only one
representative terminal is shown in FIG. 1) connected to the
session server 3 via the network 4 in addition to the medical
institution terminal 2(x) and the patient terminal 1(x) so that the
third parties other than the bidders can make donations upon
referring to the information. In addition, the information
referable by the third parties may be controlled by the management
of the session server 3 for the purpose of protection of privacy so
that the predetermined information can be concealed or access
thereto can be restricted.
[0045] (1) Direct Donation from Third Party:
[0046] A predetermined amount (for example, one dollar) may be
reflected to an amount presented by the patient or the medical
institution each time any one of the above-described third parties
clicks a donation button provided on a screen for an open session
displayed on the optional terminals 6(x) connected to the session
server 3. Further, an optional amount specified by the third party
may be sent as a donation. For example, when 1,000 dollars is made
to the patient who presents an upper limit of a payable amount of
30,000 dollars at the reverse session auction, the upper limit of
an amount payable by this patient is changed to 31,000 dollars or,
when a donation of 10,000 dollars is made to the medical
institution which represents a lower limit of a medical cost of
40,000 dollars, the lower limit of a medical cost is changed to
30,000 dollars. Changes in an amount of money is preferably
reflected in real time mode at specific time intervals.
[0047] The third party having made a donation settles the donation
sum through predetermined procedures. For example, the session
server 3 draws the amount corresponding to the donation to be
transferred to a bank account of a party whereto the donation is
made from the third party's bank account. When the third party has
experienced a trade at the session auction according to the present
invention, a unique ID number to be added to each third party can
be specified at the time of making a donation to specify the third
party's bank account from the information of this ID number. On the
other hand, when the third party makes a donation for the first
time, the third party may be made enter information for identifying
the third party's bank account in addition to personal information,
send bank account information from an optional terminal 6 or send
the bank account information by an optional means after expressing
an intention to make the donation. In addition, the third party
capable of making a donation may be limited to a manager of the
session server, that is, a one who has passed an admission
examination given in advance by a person in a managing facility of
the medical cost adjusting system.
[0048] Results of donations made by donators are stored in "(b8)
donation history" included in data items of user objects shown in
FIG. 3, and disclosed to a third party if necessary. The purpose of
the above processing is to inspire the motivation of making
donations by a third party knowing the detailed results of
respective donations made by the patient and the medical
institution during a session. The donation history is preferably
disclosed on the terminal 6(x) so that the total donated amount and
the total amount of received donations can be known.
[0049] (2) Indirect Donation from Third Party:
[0050] This is a case where the third party does not participate in
the session auction on the basis of an intention to make a donation
of a predetermined amount for a medical cost, but a specific
behavior of the third party indirectly contributes to the reduction
of the medical cost. The specific behavior of the third party is,
for example, a number-selection type lottery whose prize is finally
won when a plurality of pieces of winning factor information (A and
B) are hit (hereinafter referred to as "the lottery"). When all or
a part of bets of such the lottery is transferred to the bank
account for donations, the session server 3 shares the bets among
patients and medical institutions desiring to carry out a session
trade in the medical cost adjusting system 100, evenly or in
accordance with balances in patients' bank accounts. Further,
various distribution methods are included, for example, each
patient may directly refer to the contribution history described in
(1) above to determine a share of a donation to be received by
himself or herself on the basis of amounts of donations which have
been made by the patient to other persons.
[0051] A person who buys the lottery expects to receive a prize of
an appropriate amount when he or she wins the prize. However, when
the lottery number and the winning number specified by the
purchaser are attempted to be sent or received via a network or the
like, the data may be falsified by an illegal information operation
of a person of a malicious mind. Accordingly, the medical cost
adjusting system 100 according to the present invention makes the
lottery be held fairly without a winning number being determined
arbitrarily by a person of a malicious mind. In the case of this
embodiment, the winning factor information A is, for example, time
information to be added to an end time of a session (e.g., +4 hr).
On the other hand, the winning factor information B is preferably
information which can be uniquely specified in one session and set
on the basis of information disclosed to the general public. The
disclosed information includes, for example, average stock prices
in the New York, London and Tokyo stock markets at the end of a
session (in case of a closed market, a closing price is
applied).
[0052] The session server 3 encodes the winning factor information
A and distributes the winning factor information A to purchasers of
the lottery via the network before the time at which the winning
number is determined. A participant of the lottery selects a
predetermined number of (e.g., five) optional natural numbers from
natural numbers within a predetermined range (e.g., 0 to 9) and
buys the selected numbers as one lottery ticket during the session,
and a winning order is determined depending on the number of
winning natural numbers. The withdrawal of the purchase price for
the lottery can be settled in the same manner as the settlement of
a direct donation by a third party. The winning numbers are
determined, for example, as follows. The session server 3 adds the
winning factor information A at the end time of the object session,
and specifies as the winning factor information B a plurality of
numbers obtained from converting average stock prices of the
aforementioned plurality of stock markets at the end time (or a
succeeding time closest to end time) into dollars at the exchange
rate at the end time. A specific example is that, assuming that a
Nikkei Stock Average of the Tokyo stock market converted into
dollars at the time obtained from adding 4 to the end time of a
session is $154.04, an average stock price of the London stock
market (upper 100 companies) converted into dollars is $11,000.54
and an average stock price of the New York stock market (conversion
into dollars is not necessary) is $1,200.31, these values are each
multiplied by 100, upper and lower digits are inverted, upper 5
digits of the numbers are added, and upper five digits of the
result of the addition is determined to be the winning number.
[0053] A specific example is given below.
[0054] There can be obtained 40,541+45,000+12,003=97,544 from
summing up the following three values: [0055] Tokyo:
145.04.times.100=14,504.fwdarw.4,0541, [0056] London:
11,000.54.times.100=1,100,054.fwdarw.4,000,011.fwdarw.45,000, and
[0057] New York: 1,200.31.times.100=1,120,031.fwdarw.12,003.
[0058] Accordingly, numerals 9, 7, 5, 4 and 4 are determined to be
winning numbers and a person who hits the five numbers wins the
first prize. In addition, the digit places are inverted to prevent
the winning numbers from being affected greatly by minute changes
in stock prices. If the digit places are not inverted, anyone can
easily estimate some of the five numbers by observing changes in
stock prices and the lottery is not substantially won on the basis
of pure guessing of the five numbers.
[0059] In addition, described above is only one example and,
needless to say, a case where various corrections are made is also
included. For example, one value "97,544" taking into consideration
of digit places may be winning numbers instead of regarding that
each of the five numbers is independent of other numbers.
[0060] The session server 3 distributes key information to decode
the code and session ending time information to the purchasers of
the lottery when the winning number determination time is passed.
The purchasers of the lottery know that the value of the winning
factor information A is "+4" by decoding the winning factor
information distributed in advance by using the key information.
The determination algorithm of the winning numbers is preferably
announced to the participants of the lottery in advance or
distributed together with the code key.
[0061] By the above procedures, the purchasers of the lottery can
verify that the winning numbers are calculated from the average
stock prices and the exchange rate at the time the session ending
time information and the winning factor information A are added.
Further, according to the winning number determining method of the
present embodiment, it is possible to judge whether the winning
numbers are determined in a fair manner.
[0062] Furthermore, the winning numbers may be determined in real
time mode with the winning number determination time. Specifically,
average stock price information and exchange rate information of
the Tokyo, New York and London stock markets are stored in a
database 5 at a predetermined time interval (e.g., 1 min) so that
the patient, the medical institution and the purchasers of the
lottery can check the momentarily changing average stock price and
exchange rate information at the predetermined time interval on
respective terminals. This information is preferably displayed
visually as a graph so that the contents thereof can be known
easily. The winning number is determined also by searching in this
database 5 so that the winning numbers are determined substantially
in real time mode by specifying the winning number determination
time, for example, after few minutes from the end of the session.
This method is effective to inspire the sense of presence in
processing up to the determination of the winning number and an
intention to buy the lottery.
[0063] (3) Non-Personal Donation:
[0064] The medical cost adjusting system 100 of the present
embodiment also accepts donations from parties other than
individual persons. FIG. 7 is a schematic diagram showing a flow of
a donation. For example, a part of an interest or a share
accompanied with a commodity treated by a bank, an association or a
foundation is collected to form one financial institution
(hereinafter referred to as "the M bank"), and a donation is sent
from the M bank to the medical cost adjusting system 100, and then
the session server 3 transfers the donation from the account of the
M bank to the patient's bank account. In addition, the amount of
the donation by the M bank is changed in accordance with the
deposit balance or the operation result thereof, and the donation
is shared in accordance with the result of past donations
distributed evenly to patients.
[0065] Here, returning to the flowchart shown in FIG. 4, the
session server 3 transits to the start of a real reverse session
after confirming session members (i.e., user objects) to
participate in the reverse session (step S44).
[0066] First, a timer and various parameters, which will be
described later, are initially set (step S45). The timer is
provided to judge whether a donation is made and, if made, to judge
and carry out processing for reflecting an amount corresponding to
the donation to a medical cost presented by a patient or the above
both institutions, and moreover, ending of a session and the like
at a predetermined time interval (T*.alpha.). Here, T and .alpha.
denote a parameter reviewing time interval of the user object item
shown in FIG. 3 and a variation coefficient of the parameter
reviewing time interval (.alpha.), respectively. Further, "a
desired providing amount", which is an amount presented by a
medical institution to be successfully bid when a patient makes a
bid at not less than the presented amount and "a desired obtaining
amount", which is an amount presented by a patient to be
successfully bid when a medical institution makes a bid at not more
than the presented amount as well as a specific threshold value may
be set as various parameters. Specific examples thereof include, "a
lower limit of a providing amount", which is a threshold value
price, that is, the lowest price at which a successful bid can be
made at the end of a session, and "an upper limit of an obtaining
amount", that is, the highest price at which a successful bid can
be made at the end of a session. These parameters can also be
changed at a predetermined time interval (T*.alpha.).
[0067] The session server 3 execute session processing in
accordance with the presence of the desired obtaining amount (i.e.,
a successful bid amount desired by a patient) and the upper limit
of an obtaining amount (i.e., a largest amount payable by a
patient).
[0068] (i) Case Where a Bid is Made (Yes in Step S47):
[0069] When a patient specifies a desired obtaining amount (Yes in
step S49) and the least amount (the least providing bid amount) of
a desired providing amount for which a bid is made by a medical
institution is less than or equal to the desired obtaining amount
(Yes in step S51), an agreement and a deal is made between the
patient and the medical institution, then the session is ended
before a predetermined session ending time (step S52). On the other
hand, even if the least providing bid amount is larger than a
desired obtaining medical cost (No in step S51), when the least
providing bid amount is not larger than the upper limit of an
amount (i.e., an upper limit of an amount payable by the patient),
the session is ended upon conclusion of a negotiation or, when a
donation is made (Yes in step S57), the addition of the amount
corresponding to the donation to the desired obtaining amount or
the subtraction of the same from the least providing bid amount are
repeated until the session ends (step S46). Further, when a
reduction rate of the least providing bid amount per unit time
during a session is large, step S57 also returns to step S46 and
takes the same effect as that of the addition and subtraction of
the amount corresponding to the donation. That is, in the case
where the reduction rate of the least providing bid amount per unit
time is large, the medical institution lowers the presented amount
during the session, and this means that the medical institution has
a strong intention of making a successful bid at the auction and
desires to positively provide a medical service. Accordingly, the
session server 3 needs to make a negotiation be concluded easily so
that a deal is done in the next session. For this purpose, the
desired obtaining amount or the least providing bid amount is
adjusted in step S46.
[0070] Furthermore, when a donation is not made or the reduction
rate of the least providing bid amount per unit time is too small
and the medical institution therefore has no intention to
positively make a successful bid (No in step S57), the session
server 3 does not intentionally lower the desired obtaining amount,
but makes a correction by adding a predetermined increase to the
current desired obtaining amount. However, when the patient
specifies the upper limit of an obtaining amount, the session
server 3 adjusts the increase of the desired obtaining amount to
not more than the upper limit thereof (step S60), or when the
patient does not specify the upper limit of an obtaining amount,
the session server 3 adjusts the obtaining amount by adding the
predetermined increase to the desired obtaining amount to the
desired obtaining amount in the next session (step S59).
Thereafter, the session server 3 repeats this series of processing
at the predetermined time interval until the session ending time
comes.
[0071] (ii) Case Where No Bid is Made (No in Step S47):
[0072] The session server 3 repeats the addition of the donation to
the desired obtaining amount or the subtraction of the same from
the least providing bid amount (steps S48 and S46), and ends the
session when a session timeout occurs (Yes in step S48) assuming
that the negotiation has not been concluded and the deal is
therefore not done (step S62).
[0073] Note that the processing for increasing the desired
obtaining amount at the predetermined time interval in steps S59
and S60 above appropriately incorporates the relationship between a
demand and a supply in a trade. That is, when a desired obtaining
amount is raised or a least providing bid amount is lowered as a
result of collecting donations, there is a high possibility of
making a successful bid at an amount of not less than a current bid
amount and therefore, the desired obtaining amount needs not to be
intentionally changed. On the other hand, when donations cannot be
collected, it is difficult to make a successful bid at the current
bid amount and therefore, the desired obtaining amount is revised
up for a predetermined increased amount (an increased value at the
time of revising up the obtaining amount) within the range of the
upper limit of an obtaining amount to bring the desired obtaining
amount close to the least providing bid amount.
[0074] In addition, instead of automatically carrying out the above
session processing under the management of the session server 3,
the session manager may intervene in the observation of a trade by
the patient and the medical institution by changing the least
providing bid amount (step S46). Some patient has no intention to
purchase a medical service by daringly lower the desired obtaining
medical cost or, on the other hand, some patient hopes to receive a
medical service from the medical institution at any cost. The
session members thus have various levels of intentions to make a
successful bid. At the auction of the present embodiment, an
intention to make a successful bid of a party concerned in the
trade is reflected to a change in the desired obtaining medical
cost or the least providing bid amount regardless of whether the
session processing is carried out automatically or intervened by a
human operation.
[0075] Further, an objective judgment of a third party on the
appropriateness of the desired obtaining medical cost and the least
providing bid amount may be incorporated to the aforementioned
automatic determination algorithm. A specific example is that, the
third party observing the session enters "appropriate" or
"inappropriate" to vote the idea thereof about an adjusted medical
cost by pressing a button on the optional terminal 6(x), or sends a
questionnaire created by text entry to the session server 3. The
session server 3 may objectively evaluate the above information by
statistical analysis to raise or lower the current bid price.
[0076] The above-described automatic determination algorithm for a
medical cost is applied when a medical service presented by the
medical institution is determined in the reverse session under the
initiative of the patient. On the contrary, there is an algorithm
for determining a medical cost in the regular session under the
initiative of the medical institution, that is, the providing side
in the reverse session. FIG. 5 shows the entire structure of the
algorithm. FIG. 6 shows procedures of a trade in the regular
session. The regular session is a form wherein the medical
institution puts up a medical service at a network auction and each
patient makes a bid for the medical service. The regular session
auction can be made carried out as a basic form when a
conscientious medical institution provides a medical service at a
low price.
[0077] The integration of the reverse session with the regular
session for supplementation is similar to the case where the
regular session is integrated with the reverse session for
supplementation. The operation procedures of the regular session
are basically the same as those of the reverse session. In order to
integrate the both sessions by eliminating the difference
therebetween, the session server pucks up a patient who makes a bid
at the regular session auction (i.e., the passive/obtaining type
user object) together with introducing a patient, who makes a bid
at the reverse session auction (i.e., the active/obtaining type
user object), into the regular auction as a member thereof. At this
time, the session server narrows down the number of target patients
to a specific number in the same manner as in the reverse
session.
[0078] Further, in the case of the regular session, since the
relationship between the seller and the bidder is exactly opposite
to that in the reverse session, the desired obtaining amount is
replaced by the desired providing amount, the least providing bid
amount by the largest obtaining bid amount, the least providing bid
amount by the largest obtaining bid amount, and the upper limit of
an obtaining amount by the lower limit of a providing amount,
respectively. In addition, the largest obtaining bid amount
represents the largest amount of all desired obtaining amounts and
the lower limit of a providing amount represents the lower limit of
an amount at which a medical institution can carry out a medical
service.
[0079] In addition, when either session is carried out as a base,
the medical institution really diagnoses the patient and the
medical institution and the patient reconsider each other's
information, then the patient finally judges whether to receive a
medical service and the medical institution finally judges whether
to give a medical treatment. That is, the medical institution can
cancel a successful bid upon knowing that it is difficult to
collect a medical cost as a result of real diagnosis. On the other
hand, the medical institution is obliged to provide a medical
service at the price corresponding to the successfully-bid medical
cost upon judging that the medical cost is collectable. Further,
the session may be constructed so that, when the medical
institution participating in the session adjusts a medical cost
including a cost for an expected trouble with the patient in
addition to a real necessary medical cost and no trouble however
occurs after the medical service is really given, the trouble cost
is returned to the patient. The present invention can thus provides
the system and the technique taking into consideration of the
actual circumstances in the field of real medical treatment.
[0080] According to the medical cost adjusting system 100 or 200 of
the present embodiment, since a seller and a buyer whose demands
are optimally match to each other can be found quickly by virtue of
the integration of the both sessions, a time required to determine
a medical cost can be shortened and, at the same time, the medical
cost can be suppressed to a rational and reasonable amount. That
is, since the mechanism of adjusting a medical cost under the
market principle is adopted, general citizens can accept medical
treatments for diseases at optimum medical costs so that an
unreasonable rise of a medical cost can be suppressed.
<Application Example: Integration of Medical cost Adjusting
System 100 or 200 and Life Insurance Policy Trading>
[0081] Described next will be an effective example for the case
where, for example, an insured person suffering from a disease
desires to receive a medical service and to apply a death benefit
from his or her life insurance policy to the medical service,
however, since the death benefit should be received by the bereaved
family, the insured person cannot receive the medical service in
his or her lifetime. This is a system having the integrated form of
the above session trade of a medical service in the medical cost
adjusting system 100 or 200 with a session wherein a life insurance
policy of an insured patient is traded, and a schematic diagram
thereof is shown in FIG. 8. The life insurance policy trading means
that, in the regular life insurance policy trading, a person who
desires to be insured makes a bid at a desired price for a life
insurance policy presented by an insurance company or, in the
reverse life insurance policy trading, an insurance company makes a
bid for a life insurance policy at a desired price presented by a
person who desires to be insured and the insurance company finally
sells the life insurance policy to the person who desires to be
insured.
[0082] When a session for trading a life insurance policy is opened
and an insurance company makes a successful bid for the commodity,
then the life insurance policy is determined to be assigned or
resold to the person who desires to be insured, the medical cost
adjusting system subsequently applies the amount for assignment of
the life insurance policy Including a medical insurance) to the
desired obtaining medical cost for receiving a medical service, and
opens the reverse session. That is, the assignment money owned by
the patient but not given thereto during the lifetime thereof is
used at the auction to receive the medical service. Thus, this
insurance policy is essentially a life insurance policy, and when a
patient suffers from a disease after contracting the insurance for
the bereaved family to receive the insurance money at the time of
his or her death and therefore needs money before his or her death,
it is possible to raise a medical cost at the session auction
according to the present invention and can avoid agreeing to
one-sided price adjustment by a medical institution. Accordingly,
according to the system in this application example, it can be
expected that the patient undergoes a medical consultation at a
lower price than a conventional medical cost. Further, as in the
aforementioned system 100 or 200, a donation is collected in the
session and the amount corresponding to the donation may be
subtracted from a medical cost to be demanded by the medical
institution and paid by the insurance company. In addition, the
life insurance policy to be traded in the insurance service session
includes a viatical and life settlement policy.
[0083] Next, features of the life insurance policy trading will be
described.
[0084] 1. Qualification to Participate in Session [0085] It is
desirable to request a person who desires to be insured (e.g., a
patient) and to be a session member of the life insurance policy
trading to undergo a periodic health examination and the session
server can request the person for disclosure of the result of the
examination. The insurance company needs to grasp the physical
condition of the person who desires to be insured for judgment of
appropriateness of selling the life insurance policy. However, if
the insurance company carries out this health examination, a fair
cost is needed. The patient bears this cost resulting in reduction
of the insurance due thereof. [0086] Bidders for the life insurance
policy put up by the patient at the life insurance policy trading
include insurance companies, and does not exclude the insurance
company which puts the life insurance policy on sale. When the
insurance company which puts the life insurance policy on sale
finally makes a successful bid to buy the commodity, it is
considered that the profit of the insurance company whereto the
commodity is assigned increases since the procedures of assignment
to another insurance company or the like can be simplified.
[0087] 2. Adjustment of Insurance Due of Life Insurance Policy
[0088] It is preferable that the number of contractors of the life
insurance policy being traded at the auction is displayed on the
terminal connected to the session server, and the insurance due of
the next month is changed in accordance with a change in the number
of insurers in each month or furthermore, a result of simulation
representing the relationship between the predicted number of
contracted insurers and insurance dues to inspire a motivation to
be insured. [0089] As it can be said in general that an infant or
an aged pays more costs to a medical institution than people in
their ages of twenties and thirties, an average medical cost
differs depending on a patient's age. Accordingly, it is preferable
that a basic data for adjusting an insurance due is on the basis of
probability data obtained from a death rate of people in each age.
It is further preferable that information presented by the patient
who is a session member of the auction trade of the medical cost
adjusting system 100 or 200. The reason is that an insurance due is
adjusted taking into consideration of personal information of each
patient since a lifestyle habit (particularly, smoking) greatly
affects a prevalence rate of the patient.
[0090] 3. Donation Function [0091] The life insurance policy
trading alone also has a function to accept a donation. Since the
donation reduces a burden of an insurance company, the insurance
company gives a preferential treatment regarding an insurance due
to a donator, that is, reduces the insurance due. This rule may be
applied not only to a newly insured person but to an already
insured person. The preferential amount can be varied on the basis
of, for example, annual income and expenditure on premise that the
insurance due of the donator is lower than that of a person who has
not made any donation. It can be considered that insurance dues of
persons each of whom has made a donation more than once are
uniformly reduced, or an insurance due to be paid by a person next
time will be treated more preferentially as the total amount of
donations made by the person increases. [0092] Further, it is
preferable that an insurance due of a person who has made a
donation via the M bank is also treated preferentially. The M bank
operates collected deposits, returns a part of the obtained fund to
an insurance company, and the insurance company reduces insurance
dues of depositors of the M bank. [0093] Instead of the direct
transfer of donations to insurance companies, donations to
insurance companies may be collected uniformly and then are
reassigned to the insurance companies followed by determination of
insurance dues. [0094] It is preferable that result information of
donations (e.g., number of donations, a total amount of donations,
a rate of a donation to an asset/income of each donator) is stored
in a database or a user object and displayed on a terminal in a
comparable form with information of other donators. The reason is
that, knowing donation results of other donators may lead to the
inspiration of an intention to make a donation upon objective
evaluation of own donations. [0095] The result information related
to donations (numeric values and comments) may be usable as a self
appeal information to ask a third party for a much donation. A
party who has made a much donation is rewarded to induce donations
to the auction.
[0096] Thus, in the case of the life insurance policy trading, a
donation leads to the reduction of an insurance due of the donator
and, as described above, the donator is qualified to receive a
support of a donation from another party at the auction so as to
receive a desired medical service at a reasonable price.
<Other Functions of Medical Cost Adjusting System>
[0097] The following should be noted when really operating the
medical cost adjusting system according to the present invention.
[0098] (a) The management authority of the medical cost adjusting
system demands a participant of the auction to comply with laws and
regulations and strictly carry out an admission examination to
prevent the leakage and the illegal use of personal information and
business information between traders. Therefore, a predetermined
compliance of the management authority can be specified to have the
session member make an oath not to use the auction trade for an
illegal purpose in advance. [0099] (b) A patient who desires to put
up a commodity at the auction of the medical cost adjusting system
according to the present invention may be made obliged to contract
a medical insurance of an insurance company tied up with the
management authority of the medical cost adjusting system. [0100]
(c) Since an auction is originally executed on the basis of the
adjustment of a price on the basis of competition of a plurality of
auctioneers, it is meaningless without a plurality of bidders
present at the auction. Accordingly, a plurality of medical
institutions have made contracts with the management authority of
the medical cost adjusting system to participate in the auction as
session members as a precondition. In addition, the session members
include general members (general citizens and possible patients),
members of medical institutions (hospitals and doctors) and members
of insurance and financial institutions.
[0101] Furthermore, in the case of a network auction, there is a
fear that another person gets around the regulations of the
aforementioned compliance and participates in the auction by
disguising himself as the authenticated participant. Therefore, the
medical cost adjusting system is preferably provided with the
following functions. For example, during the time a patient
participates in the session, there are detected (a) a voice (by a
microphone), (b) an expression on the face (by a camera), (c) an
iris (by a camera), (d) a retina (by a camera), (e) voice printing
(by an exclusive-purpose measuring equipment), (f) a body
temperature (by a clinical thermometer), (g) a pulse (by an
exclusive-purpose measuring equipment), (h) a brain wave (by an
exclusive-purpose measuring equipment), (i) a blood pressure (by an
exclusive-purpose measuring equipment), (j) a cutaneous electrical
resistance (by an exclusive purpose measuring equipment) and the
like to be sent to the session server in real time mode or at a
predetermined time intervals via various biographical information
detection devices (the above measuring equipments in parentheses
for detecting various pieces of biometrics information) installed
in the periphery of the patient terminal (x). The same functions
are required in the case where a medical institution, an insurance
company and the like participate in the session.
[0102] (A) Personal Authentication Function:
[0103] The session server compares the sent information about the
above physical and behavioral characteristics (biometrics
information) of a person with the master data collected from the
patient and registered in the database at the time of the admission
examination and, if the two pieces of information do not match to
each other, the session server stops making the person
participating in the session upon judgment that the person is not
the one permitted to be registered. In addition, a medical
institution may be authenticated in the same manner as the personal
authentication. In this case, only an institution registered in
advance as a medical institution has the right to participate in
the auction.
[0104] (B) Lie Detecting Function:
[0105] Such a trade related to a medical treatment or an insurance
as the trade according to the present invention is different from
other commodity trades in that, even when an authenticated person
participate in the session, the health condition of the person
needs to be grasped or there is a great importance in confirming
that presented information is correct. Accordingly, the
aforementioned biometrics information is detected and used to
detect a lie. Specifically, it should be observed (a) a shaking or
a falsetto of a voice, (b) a sulky look of an expression on the
face, (g) rapid rising of a pulse, (i) rapid rising of a blood
pressure, (j) a change caused by sweat in a cutaneous electrical
resistance, and the like.
[0106] Furthermore, (b) an expression on the face, (f) a body
temperature, (g) a pulse, (i) a blood pressure and the like may be
analyzed and compared with data of a human being in a usual
condition to simply grasp the health information of the
participant. An emotional sense can also be known from (a) a voice,
(b) an expression on the face, (g) a pulse, (i) a blood pressure
and the like. The personal authentication, the lie confirmation,
the emotion recognition, and the health check can be thus carried
out simultaneously on the basis of the biometrics information of
the participant of the session resulting in further improvement of
the reliability of a trade in a session.
[0107] In addition, the above-described functions are provided not
only for the medical cost adjusting system but also for the life
insurance policy trading.
[0108] While the invention has been described with reference to a
specific embodiment, the description is not meant to be construed
in a limiting case. Various modifications of the disclosed
embodiment, as well as other embodiments of the invention, will be
apparent to persons skilled in the art upon reference to this
description. It is therefore contemplated that the appended claims
will cover any such modifications or embodiments as fall within the
true scope of the invention.
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